What is a Medical Bill Advocate?

Health Insurance

By Cheryl Welch

Being sick is stressful and painful, and high health-care bills only make a bad situation more difficult. It’s even worse when you’re being charged excessively or erroneously. By some estimates, up to 80% of medical bills contain overcharges.

A medical bill advocate can significantly reduce costs for individuals, employers and employees. They do this by reviewing medical bills for abusive, fraudulent and erroneous billing practices.

» MORE: Learn your options for medical bill debt

Benefits for employers

Medical bill advocates offer great advantages to employers:

  • Reduced health plan costs: Lower medical claim costs for employees translate into lower costs for employers.
  • Increased employee productivity: Investigating medical bills can be time-consuming and frustrating. Billing departments are typically available only during business hours, and calling them takes employees away from work. A bill reduction service can free up employee time and eliminate frustrations.
  • Improved employee satisfaction, loyalty and retention: Saving money makes employees happy. Receiving assistance with health-care providers improves their satisfaction as well.
  • Reduced burden on human resources: In the absence of a medical cost reduction service, many employees go to their human resources department with problems. Employers can proactively address employee questions by offering them the right resources.

When you use a medical bill advocate, the amount of the reduced bill plus the commission will be less than the original bill. If an advocate is unable to reduce the patient’s costs, the advocate won’t charge.

Benefits for employees

It’s not only employers that benefit from medical bill advocacy. Besides saving on medical costs, employees receive:

  • Confidential support: Employee data is safe, and all cases are 100% confidential.
  • Time savings: Sorting medical bills and health insurance appeals takes hours. Medical bill advocates handle this so that employees can focus on other responsibilities.
  • Power to make informed decisions: Advocates educate employees to make better health-care choices.

Services offered by medical bill advocates

Services vary by company, but you should look for these benefits:

  • Bill audits: The advocate analyzes bills for errors and overcharges.
  • Bill negotiations: The advocate employs experienced teams that negotiate and reduce out-of-pocket expenses.
  • Insurance claims: The advocate appeals denied insurance claims to ensure the patient is being treated fairly.
  • Education: The advocate holds speaking engagements and one-on-one coaching sessions to improve clients’ understanding of medical costs and plans.

» MORE: Learn your options for medical bill debt

Case study

Let’s look at a real-life example. An employee cut his finger while making dinner and went to a network hospital. He received five stitches from a plastic surgeon. Insurance covered everything except for the out-of-network surgeon. His bill was for $8,500.

Our firm convinced the surgeon to accept the amount paid by the patient’s insurance company as payment in full. That amounted to a 94% discount and a savings of $8,000.

Medical bill advocates provide employers and employees with a simple solution. They connect patients with a team of highly trained experts to take the frustration out of dealing with the medical system. Their knowledge and negotiation skills reduce the stress of sudden illness. This allows patients to focus on what matters most: feeling better.